View Information Collection Request (ICR) Package
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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
1660-0005
ICR Reference No:
201704-1660-001
Status:
Historical Active
Previous ICR Reference No:
201310-1660-003
Agency/Subagency:
DHS/FEMA
Agency Tracking No:
Title:
National Flood Insurance Program Claims Forms
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
07/31/2017
Retrieve Notice of Action (NOA)
Date Received in OIRA:
04/28/2017
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
07/31/2020
36 Months From Approved
07/31/2017
Responses
49,423
0
97,242
Time Burden (Hours)
31,633
0
72,548
Cost Burden (Dollars)
0
0
0
Abstract:
The Claims Forms used for the National Flood Insurance Program are used by policyholders and adjusters to collect the information needed to investigate, document, evaluate, and settle claims against National Flood Insurance Program policies for flood damage to their insured property or qualification for benefits under Increased Cost of Compliance coverage.
Authorizing Statute(s):
PL:
Pub.L. 90 - 448 1301
Name of Law: The Housing ans Urban Development Act of 1968
PL:
Pub.L. 93 - 234 2
Name of Law: The Flood Disaster Protection Act of 1973
EO: EO 44 Name/Subject of EO: CFR 62.20 Claims Appeals
PL:
Pub.L. 103 - 325 555
Name of Law: National Flood Insurance Reform Act
US Code:
42 USC 4001
Name of Law: The National Flood Insurance Act of 1968
US Code:
42 USC 4102a
Name of Law: National Flood Insurance
EO: EO 1361 Name/Subject of EO: The National Flood Insurance Act of 1968
PL:
Pub.L. 108 - 264 205
Name of Law: The Bunning-Bereuter-Blumenauer Flood Insurance Reform Act (FIRA) of 2004
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
82 FR 4372
01/13/2017
30-day Notice:
Federal Register Citation:
Citation Date:
82 FR 15231
03/27/2017
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
16
IC Title
Form No.
Form Name
Statement as to Full Cost of Repair or Replacement under the Replacement Cost Coverage, Subject to the Terms and Conditions of this Policy
086-0-12
Statement as to Full Cost of Repair or Replacement under the Replacement Cost Coverage, Subject to the Terms and Conditions of this Policy
Adjuster Certification Application
086-0-21
Adjuster Certification Application
Adjuster Preliminary Damage Assessment
086-0-20
Adjuster Preliminary Damage Assessment
Cause of Loss and Subrogation Report
086-0-16
Cause of Loss and Subrogation Report
Increase of Compliance Proof of Loss
086-0-10
Increase Of Compliance Proof of Loss
Increased Cost of Compliance (ICC) Adjuster Report
086-0-19
Increased Cost of Compliance (ICC) Adjuster Report
Manufactured (Mobile) Home/Travel Trailer Worksheet
086-0-17
Manufactured (Mobile) Home/Travel Trailer Worksheet
Manufactured (Mobile) Home/Travel Trailer Worksheet (Continued)
086-0-18
Manufactured (Mobile) Home/Travel Trailer Worksheet (Continued)
NFIP Claims Appeal
National Flood Insurance Program Final Report
086-0-14
National Flood Insurance Program Final Report
National Flood Insurance Program Narrative Report
086-0-15
National Flood Insurance Program Narrative Report
National Flood Insurance Program Preliminary Report
086-0-13
National Flood Insurance Program Preliminary Report
National Flood Insurance Program Worksheet - Contents - Personal Property
086-0-06
National Flood Insurance Program Worksheet - Contents - Personal Property
Notice of Loss
086-0-11
Notice of Loss
Proof of Loss
086-0-9
Proof of Loss
Worksheet - Building
086-0-07
Building - Worksheet
Worksheet - Building (Continued)
086-0-08
NFIP Worksheet Building
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
49,423
97,242
0
-47,819
0
0
Annual Time Burden (Hours)
31,633
72,548
0
-40,915
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Changing Regulations
Burden decreases because of Program Change due to Agency Discretion:
Yes
Burden Reduction Due to:
Cutting Redundancy
Short Statement:
The NFIP DSA had decrease from 965,000 policies in 2012 to a total of 639,054 policies today (2016). As part of the NFIP Transformation, several forms that the policyholders sees and is required to complete, with the assistance of an adjuster, have been simplified for easier use, thereby decreasing the number of hours to complete. Additionally, with the last filing of the collection in 2013, that was based upon numbers of claims in the post-Superstorm Sandy environment and the number of overall claims has greatly decreased since that time.
Annual Cost to Federal Government:
$4,001,532
Does this IC contain surveys, censuses, or employ statistical methods?
No
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Levi Harrell 202 212-3968 levi.harrell@fema.dhs.gov
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
04/28/2017
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